Individual
ASHFORD DURHAM WESTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
QMHP, LPC
Contact information
Practice address
440 KNOX ABBOTT DR STE 400, CAYCE, SC 29033-4353
(843) 501-1099
Mailing address
419 E 7TH ST STE 207, THE DALLES, OR 97058-2676
(541) 296-5452
(541) 296-1537
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
WA
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
9261
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1699745794
—
OR
Enumeration date
02/06/2017
Last updated
02/26/2024
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